SECRETS Neurology - Alzheimers

Question 1

pathology

Answer 1

neurofibrillary tangles = hyperphosphorylated tau proteins, accumulate intracellularly & correspond with degree of dementia

B-amyloid plaques = extracellular aggregates of B-amyloid protein (cleaved from APP)

Question 2

amyloid angiopathy

Answer 2

deposition of B-amyloid protein in intracranial vessels –> weaken vessel walls

lead to intracranial hemorrhage

Question 3

common causes of dementia in elderly

Answer 3

1) alzheimers

2) multi-infarct vascular dementia

Question 4

vascular dementia

Answer 4

cumulative effect of multiple small or large infarcts

presents with focal neuro deficits

Question 5

pick’s disease

Answer 5

selective atrophy of frontal and temporal lobes
parkinsonian sx, personality changes

intracellular tau protein aggregates = Pick bodies

Question 6

alzheimers tx and why

Answer 6

cholinesterase inhibitors - compensate for decreased cholinergic activity
Donezepil

alzheimers = selective destruction of cholinergic neurons

Question 7

avoid what depression tx in alzheimers?

Answer 7

TCA

anticholinergic effects

use SSRI for tx depression instead

Question 8

alzheimers affects what brain areas?

Answer 8

hippocampus early –> memory loss

Question 9

alzheimers inheritance

Answer 9

sporadic

genetic - genes on chr 1, 14, 19, 21

21 = APP gene (early onset in Down syndrome)
19 = ApoE gene (E4 allele - late onset)